Insurance Authorization Verification Specialist II - Rev Cycle

Position Summary:

Verifies insurance policy benefit information and obtains Authorization/ Precertification, prior to the patient's visit or scheduled admission, or immediately following admission. Assist in identifying problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained.

UTHealth is seeking a highly motivated experienced Insurance Verification Specialist III (Remote) to join our dynamic referral team. This team plays a critical role in ensuring that any referrals sent from outside hospitals to UTHealth physicians are processed efficiently and accurately. Working in a high-volume, call center environment, you will be the first point of contact for patients referred to our doctors, ensuring a seamless experience from referral to scheduling.

Key Responsibilities:

• Verify medical insurance coverage for all referred patients.
• Contact patients directly to obtain and confirm insurance information.
• Coordinate referrals from external hospitals to UTHealth physicians.
• Deliver exceptional customer service by guiding patients through the process until they are scheduled with their referred doctor.
• Maintain efficiency and accuracy in a fast-paced, high-volume environment.
• Collaborate with clinical and administrative teams to resolve any insurance or referral issues

• Location: Remote (2- 4 weeks onsite for training @ 1851 Crosspoint Ave, 77054) , meetings, additional training, etc.

• Must live in Texas (TX). This is a Remote position, and you must reside in Texas

• Must be able to attend any required onsite meetings

• **We DO NOT provide lodging or mileage reimbursement for training**

Position Key Accountabilities:

• Verifies insurance policy benefits for new and returning patients with carriers and employers.
• Assures all insurance information has been completely and accurately obtained.
• Documents all pertinent insurance information.
• Documents information given or received to support actions taken on insurance charges or referral issues.
• Identifies special policy clauses or pre-existing conditions and verifies effective date of policies.
• Educates patients and families on insurance issues.
• Communicates patient's fiscal responsibility in a professional manner.
• Notifies appropriate work units of patient's insurance coverage, authorizations, or status.
• Identifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures.
• Receives and reviews UT-H Health Science Center Managed Care contracts to understand the contract provisions.
• Interprets managed care contracts for insurance coverage.
• Provides support to Revenue Cycle work units and other work units as assigned.
• Performs other duties as assigned.

Certification/Skills:

• None

Minimum Education:

High School Diploma or equivalent required Some college preferred

Minimum Experience:

3 years of related experience required

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.

Residency Requirement:

Employees must permanently reside and work in the State of Texas.